Separation of Abortion Payments in the Marketplaces

The Trump Administration is trying to make it more complicated and burdensome for health plans to cover abortion care. The rule impacts qualified health plans – health plans that are on the Affordable Care Act (ACA) Marketplace and include ACA protections, such as the essential health benefits and potential subsidies.

Federal policies, such as the Hyde Amendment, prohibit federal funds from covering abortion except in the limited circumstances. States, however, can allow or require health plans to cover the abortion care that pregnant people need. When that happens, insurers have to collect at least $1 per month as a premium covering abortion services. They then keep that $1 separate from the rest of the premium to ensure no federal funds are used for abortion services.

This rule takes that separation requirement to the point of absurdity. It requires insurers to send enrollees two separate bills – one for the abortion part of the premium and another for the rest of the coverage. Apparently it’s not enough for the insurer to separate the funds, now the enrollee must send two checks.The rule is dangerous. It stigmatizes abortion care, making it seem separate from other basic health care services. It could lead to confusion and people losing health care coverage. Additionally, the administrative and reporting burden will likely raise costs, leading to higher premiums or encouraging health insurance plans to drop abortion coverage all together. The rule goes into effect June 27, 2020 unless it is stopped in the courts first.